The U.S. Centers for Disease Control and Prevention declared last week “Get Smart About Antibiotics Week” and partnered with health care institutions, including UPMC, to share information about antibiotic resistance. We asked Louise-Marie Oleksiuk, clinical pharmacy specialist in infectious diseases and antimicrobial stewardship at UPMC, to tell us more about this ongoing problem.

What is antibiotic resistance, and how does it happen?

Antibiotic resistance is when bacteria that would normally be treated with certain antibiotics are no longer effectively destroyed by those medications, allowing the infection to continue. This happens because the bacteria has undergone genetic mutations that allow it to survive antibiotic treatment. We sometimes call these antibiotic-resistant bacteria “superbugs.” Factors that can increase the development of superbugs include: the unnecessary use of antibiotics, using the wrong type of antibiotic or not taking the antibiotic as prescribed. As these superbugs become more prevalent, we're running out of antibiotics that are able to treat them. According to the CDC, antibiotic resistance is possibly the most important infectious disease threat we face. Each year, more than 2 million Americans get infections that are antibiotic-resistant, and at least 23,000 people die as a result.

Can't we just invent new antibiotics?

Developing any new drug requires years of laboratory research, followed by several phases of clinical trials in animals and humans. It can often take more than a decade and is very expensive. Bacteria mutate on a much faster timeline. Therefore, we must use currently available antibiotics only when necessary to help extend the length of time they are effective. This would provide fewer opportunities for mutated bacteria to get a foothold and become superbugs.

What can I do? What should I expect my hospitals to do?

Antibiotic overuse and unnecessary use are the biggest contributors to the increase in development of superbugs. You should only use antibiotics when your health care provider determines it is necessary. If you are prescribed an antibiotic, you should complete the entire antibiotic course exactly as prescribed. Viral infections, like the flu, cannot be treated with antibiotics. Hospitals and health care providers try to prevent the development of antibiotic resistance by following good “antibiotic stewardship” practices. This includes ensuring that all patients get antibiotics only when necessary and that if necessary, only the right antibiotic is used, at the right dose, route and frequency, and for the shortest effective duration. UPMC has one of the nation's oldest and most-experienced antibiotic stewardship programs. Often when a health care provider wants to prescribe an antibiotic to a patient, especially for infections and antibiotics more prone to contributing to antibiotic resistance, we involve a team that reviews the infection and the requested antibiotic to make sure that antibiotic stewardship practices are followed.

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